| Objective1.To investigate the current situation of self-management behavior,kinesiophobia of heart and self-perceived burden level in parients with acute myocardial infarction,and to explore the influence factors of self-management behavior in patients with acute myocardial infarction.2.To explore the effects of health education based on BCW on patients with acute myocardial infarction on self-management behavior,kinesiophobia heart and self-perceived burden.Methods1.From May to July in 2019,acute myocardial infarction patients who met the inclusion and exclusion criteria in the cardiology ward of two first-class hospitals in Tianjin were investigated with a questionnaire about general information,the coronary artery disease self-management scale(CSMS),Tampa Scale for Kinesiophobia Heart(TSK-SV Heart)and Self Perceived Burden Scale(SPBS).Descriptive statistical analysis,t test,one-way anova,Pearson correlation analysis and multivariate stepwise regression analysis were by SPSS 21.0.2.A total of 80 patients with acute myocardial infarction who were hospitalized in the cardiology ward of first-class hospitals in Tianjin from August to November 2019 were selected.The control group was given routine nursing,and the intervention group was given health education intervention based on BCW theory on the basis of routine nursing.Intervention was divided in-hospital and out-of-hospital intervention.The in-hospital intervention began on the second day of admission and was divided into 5 sessions,each lasting 25-30 minutes.After discharge,the patients were followed up by telephone and We Chat once a week,a total of 4 times,each time 15-20 minutes.The results were evaluated on the second day of admission,the day of discharge and 4 weeks after discharge.The effect The coronary artery disease self-management scale(CSMS),Tampa Scale for Kinesiophobia Heart(TSK-SV Heart)and Self Perceived Burden Scale(SPBS)were used to evaluate the effect.Repeated measures of variance,two independent samples t test,paired samples t test and chi-square test were used for statistical analysis.Results1.In this study,188 patients with acute myocardial infarction were investigated.Their self-management behavior score was(74.71±8.66),and the score index was 55.34%,which was at a low level.From high to low,the standardized scores of each dimension were emotion management,daily life management and disease medical management.The score of Kinesiophobia heart was(51.72±7.78),and the level was higher.The score of self-perceived burden was(31.84±6.75),which was at the level of moderate burden.Single factor analysis demonstrated that"age","BMI","educational level","marital status","occupational status","previous angina pectoris","combined hypertension","heart function classification","kinesiophobia heart"and"self-perceived burden"had significant effects on self-management behavior of patients with acute myocardial infarction.The results of multivariate analysis showed that"BMI","educational level","Kinesiophobia heart"and"self-perceived burden"were the influencing factors of self-management behaviors in patients with acute myocardial infarction,and the coefficient R~2 of predicting self-management behaviors was 48.9%.2.At the end of the intervention,a total of 75 patients with acute myocardial infarction had completed all data collection during the intervention course and follow-up,including 38 in the intervention group and 37 in the control group.(1)The results of intervention show:After intervention,the total score of self-management behavior and score of each dimension in the two groups of patients with acute myocardial infarction had significant intervention effect(P<0.05).The results of comparison between-groups showed that the total score of self-management behavior,disease and medical management score and emotional management score of the intervention group were higher than that of the control group at discharge and 4 weeks after discharge,and the differences were statistically significant(P<0.05).There was no statistically significant difference in daily life management scores between the two groups at discharge(P>0.05),and the difference was statistically significant at 4 weeks after discharge(P<0.05).The comparison within-groups showed that the total score of self-management behavior and scores of each dimension of the intervention group showed an upward trend over time,and the difference was statistically significant(P<0.017).Then,the total score of self-management behavior and scores of each dimension of the control group were not significantly different in each time period(P>0.017).(2)The results of intervention show:After intervention,the total score of kinesiophobia heart and score of each dimension in the two groups of patients with acute myocardial infarction had significant intervention effect(P<0.05).The results of the between-groups comparison showed that the total score and scores of all dimensions of kinesiophobia heart in the intervention group were higher than those in the control group at discharge and 4 weeks after discharge,and the difference was statistically significant(P<0.05).The comparison within-groups showed that the total score of kinesiophobia heart and scores of each dimension of the intervention group showed a decreasing trend over time,and the difference was statistically significant(P<0.017).In the control group,the total score of kinesiophobia heart,fear and avoidance dimension of the patients showed no statistically significant difference in the comparison between-groups at the time between 4 weeks after discharge and discharge,and between 4 weeks after discharge and admission(P>0.017).There was a statistically significant difference(P<0.017)in the score of functional dysfunction dimension between the group at discharge and the group at admission,and no statistically significant difference between the group at 4 weeks after discharge and the group at admission,4 weeks after discharge and the group at discharge(P>0.017).(3)The results of intervention show:After intervention,the total score of self-perceived burden and score of each dimension in the two groups of patients with acute myocardial infarction had significant intervention effect(P<0.05).The comparison between groups showed that the total score of self-perceived burden and scores of each dimension in the intervention group at discharge and 4 weeks after discharge were higher than those in the control group,with statistically significant differences(P<0.05).The results of the within-group comparison showed that the total score of self-management behavior and scores of each dimension of the intervention group showed a decreasing trend over time,and the difference was statistically significant(P<0.017).The total score of self-perceived burden of patients in the control group was statistically significant 4 weeks after discharge compared with that at discharge(P<0.017).There were no statistically significant differences between the time of discharge and the time of admission,4 weeks after discharge and the time of admission(P>0.017).Their economic burden score showed statistically significant difference between 4 weeks after discharge and 4 weeks after discharge(P<0.017),and no statistically significant difference between 4 weeks after discharge and admission(P>0.017).There was no significant difference(P<0.017)in the scores of emotional burden at each time point.There were statistically significant differences in the score of body burden between discharge and admission,4 weeks after discharge and admission(P>0.017),and no statistically significant differences between discharge 4 weeks and admission(P<0.017).Conclusion1.In patients with acute myocardial infarction,the scores of self-management behavior and all dimensions were at a low level,the kinesiophobia heart was high,and the self-perceived burden was at a medium level."BMI","education level","kinesiophobia heart"and"self-perceived burden"are the factors influencing self-management behavior of patients with acute myocardial infarction.2.Health education intervention based on BCW can effectively improve the level of self-management behavior in patients with acute myocardial infarction.3.Health education intervention based on BCW can effectively reduce kinesiophobia hear level in patients with acute myocardial infarction.4.Health education intervention based on BCW can effectively reduce self-perceived burden level in patients with acute myocardial infarction. |
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